Reflection On Aged Care

It should be noted that during almost all violent outburst Mr. Beaird has been diagnosed with a UTI. He had the catheter removed and now wears a urine bag on his leg connected directly to his bladder. Removing the catheter has helped with number of UTI Mr. Beaird experiences. However, the bag must be emptied and cleaned multiply times throughout the day and Mr. Beaird is not physically able to assist in this daily

This essay aims to represent an argument between two view points: to remain in their own homes with ongoing support from families and the health system or going to residential aged care of elderly in Australia. Especially, it deals with the issue of increasing ageing population in Australia includes statistical information highlighting some causes and telltales. The context presented is economic and social. It also looks at the effects that increasing of the ageing population has on society, the individual and the Australian economy.

Accessible multidisciplinary services including assessment (urodynamics investigation where appropriate), diagnosis and management for people with urinary incontinence and other bladder dysfunctions.

Urinary incontinence is very common following a stroke with 40-60% of hospitalised patients experiencing it in the acute phase, 25% on discharge and one third of survivors experiencing ongoing problems at one year (Barrett 2002, Kolominsky-Rabas et al.2003).Bladder and bowel problems are common following a stroke and can have a huge impact on physical and psychological aspects of quality of life, for both patients and carers. Health care professionals can do much to help improve and manage incontinence problems in stroke patients and this starts with a good understanding of key issues. Mobility and manual dexterity problems can compound bladder and bowel symptoms because they can make toileting access difficult, other problems such as visual disturbances, dysphagia and cognition also contribute indirectly to continence difficulties. There is evidence that professional input through structured assessment and management of care, together with the involvement of specialist continence nursing services, may reduce urinary incontinence and related symptoms after stroke. Bladder and bowel care requires active management –this includes a written personalised plan, taking into consideration required assistance, personal needs and goals. This essay is an overview on the importance of timely nursing assessment and management of urinary incontinence

Before bathing/showering with soap and water prior to a procedure/surgery was accepted. It has been proven that antiseptic showering decreases skin microorganism count. Chlorhexidine gluconate products necessitate the need for several applications for the maximum antimicrobial benefit. Thus, each patient receives two preoperative antiseptic showers.

Father gets up once during night to empty his bladder and mother reports problems with bladder leakage from stress incontinence(Johnson family, personal communication, June 24, 2012).

The inspection encompasses the shape and symmetry of the abdomen, the contour, distension, and to see if there is visible peristalsis. Using light palpation, the nurse can identify guarding, tenderness, and pain. The nurse can then listen in the four quadrants of the abdomen for bowel motility and for bowel sounds Since the client is severely dehydrated due to vomiting, the integumentary system can also be assessed to identify any cutaneous problems or systemic diseases. The skin should be checked for any discoloration or rashes and

Behavioral treatments are conservative measures and are the first treatment option for patients with stress and urge incontinence. Behavioral treatments include; bladder training, pelvic muscle exercises, biofeedback and cognitive therapy. With bladder training it helps the individual from going to the toilet less frequently. Bladder training can be seen from two dimensions, going to the bathroom on schedule and also using strategies to control your bladder from urgent urine. This as a whole involves some time to practice. However, people with dementia and some other health cognitive complications cannot practice this. You may start by trying to hold off for 10 minutes every time you feel an urge to urinate. The goal is to lengthen the time between trips to the toilet until you're urinating only every two to four hours (the American College of Obstetricians and Gynecologists, 2011).

There are many conditions that may significantly slow or prevent successful potty training. This chapter will explore how to handle special conditions such as bedwetting and disability if they should arise.

First, neurological disorders can occur, as seen with Alzheimer’s disease and Parkinson’s disease, which can lead to neurogenic bladder (“Neurology/Neurogenic Bladder,” 2017). Next, physiological disorders can occur as seen with enlarged prostate in men or shortening of the urethra in women (Jaipaul, 2017). Anticipating the above changes appropriately will aid in understanding what leads to urinary retention in older adults, the resulting need of catheterizations, and the CAUTIs that can follow. Having a foundation to build on, it would be beneficial to explore what nurses can do prevent urinary tract infections in patients who require catheterization.

One scholarly journal I found summarized the conclusion of various intervention studies for the management of incontinence and promotion of continence in care home residents. Once urinary training was implemented in a facility to analyze, incontinence rates, cost of supplies and efficiency ratios, random assignment, patterns of urinary incontinence, urological evaluations to reaffirm effectiveness and pre and post cost of hourly wet/dry checks were all documented to evaluate the program. The study ended with, “managing incontinence and promoting continence in care homes is complex, requiring time and cost-efficient management procedures to contain the problem and deliver quality, achievable care.”(Flanagan et al., 2014) The cost was a major issue that deterred many facilities from executing any sort of bladder training

When I started my placement , Mrs . X who was suffering from Parkinsonism and dementia was on Indwelling urinary catheter for the management of urinary incontinence. Adhering to the results from the literature review I planned for initiating several steps to control incontinence in Mrs. X. My mentor was always with me with full support and guidelines. Fluid management was the first step started. An input output chart was kept and well maintained. Then steps wre also taken to manage constipation. Exercises were the last method practiced and the final result was really appreciable as she got a great reduction in the incontinence rate.

It is essential for the nurse to have a proper and detailed assessment to determine the most likely cause or type of UI. One of the most basic and least invasive assessment a nurse can do is to obtain a complete history. A complete history must asked questions such as onset and duration, aggravating factors, characteristics, medical history (medical conditions and medications), associated symptoms, attempted treatments and severity (Testa, p. 83). There are also different tools that a nurse can use such as the Urogenital Inventory/ Incontinence Impact Questionnaire and Bladder Diary. Using questionnaires and bladder diary can be used in order to facilitate data gathering for people who have difficulty discussing incontinence face to face. Thorough history can provide insight and help identify potentially reversible causative factors and contributing risk factors related to UI (Mauk, p. 553). It is also important to have a detailed physical assessment, which focused on genitourinary system, abdominal, rectal and neurologic system, in order to determine the pathophysiology of voiding problems. If the nurse suspects any cognitive impairment from the initial assessment Mini Mental State Examination, Mini- Cog, and/or Confusion Assessment Method can be used to determine the severity of the cognitive impairment. It also alerts the healthcare provider for the patient’ increased risked for constant incontinence and it also determines the appropriate interventions. Having a comprehensive assessment will help the healthcare provider to diagnose and establish proper

How can nurses promote comfort, dignity and privacy to patients who have issues with bowel elimination or

Rash is one of the unique manifestation of this condition. It is evanescent in nature and bright salmon pink in colour , often central clearing ,tends to be migratory and widespread.(5,6,)It is initially noticed on the limbs and trunk and less commonly on the face,neck,palm and sole.The rash is fleeting and it correlates with acute febrile episodes.7 to